Ethical Issues In Nursing: Nurse-Patient Ratios

Ethical Issues in Nursing: Nurse-Patient Ratios
Megan Harvey, Katie McKelvery,
Erica Robbins & Cassandra Tingley

St. Johns River State College
March 2018

Ethical Issues in Nursing: Nurse-Patient Ratios
Every day nurses are faced with ethical dilemmas. Challenges in these situations are becoming more and more complex due to increasing workload and sicker patients. When a nursing unit is understaffed not only are nurses more likely to become burnt out, but their patients are far less likely to receive the quality of care they deserve. The problem is that the Federal regulations require hospitals who participate in Medicare to “have ‘adequate’ numbers of licensed nurses (RN, LPN, CNA) to provide care to all patients as needed,” but the regulations

When identifying areas which are affected, the problem spans from lack of assistance with activities of daily living, to major medical errors. One study focused on improved resuscitation rates related to appropriate nurse to patient ratios. Those involved in the study site the American Heart Association’s “chain of survival” to directly correlate their evidence. “Better Nurse Staffing and Nurse Work Environments Associated with Increased Survival of In-Hospital Cardiac Arrest Patients” argues that nurses with an appropriate patient load are able to make contact with their patients more frequently, and for longer periods of time, giving those with a potential for cardiac arrest a more “timely response” to their cardiac event. Since “timely response” is the initial phase in the “chain of survival”, the subsequent steps are more likely to yield favorable outcomes. In less acute circumstances, long term outcome of understaffing can also be detrimental to patient condition. Often, when a staff member is overwhelmed with the workload, nursing actions which are perceived less critical may be pushed to the back burner. Debilitated patients may not be turned and repositioned resulting in hospital acquired pressure ulcers, which not only affects patient outcome, but also taxes the hospital

“Better Nurse Staffing and Nurse Work Environments Associated with Increased Survival of In-Hospital Cardiac Arrest Patients” states that, “In 2012, registered nurses had 11,610 incidents of MSDs (musculoskeletal disorder), resulting in a median rate of eight days away from work. Among all healthcare practitioner and technical occupations, there were 65,050 nonfatal occupational injuries and illnesses that required a median of seven days away from work.” While we are unable to attribute every workplace related injury to stress, burnout, and poor work conditions, it is easy to correlate extreme fatigue with decrease in concentration and increase in avoidable